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Biomedical subjects

N R Lackey

Publications and source records attributed to N R Lackey.

16 recordsLinked to original sources
PubMed2001

Adults' recollections of their experiences as young caregivers of family members with chronic physical illnesses.

AIMS OF THE STUDY: The aims of this study were to describe the number, kind, and intensity of caregiving activities performed by individuals who assumed caregiving responsibilities, as youngsters, for adults with chronic physical illnesses; to explore the meaning and effects of the caregiving experience on those individuals; and to examine positive and negative effects of caregiving then and now. BACKGROUND/RATIONALE: Family mobility, demographic changes, and health care system changes in the United States of America (USA) have contributed to an increasing number of youngsters under the age of 18 caring for adults with chronic physical illnesses in the home. The effects of such caregiving on youngsters and the long-term effects on them as adults require study. DESIGN/METHODS: This descriptive, retrospective study had a convenience sample of 51 adults (age range 19--68 years now, 3--19 years then) who cared for their family members diagnosed with cancer, stroke, cardiovascular disease, multiple sclerosis or amyotrophic lateral sclerosis, respiratory disease, diabetes, or arthritis. Demographic data and caregiving data were analysed using descriptive statistics. The semistructured interview data were analysed using content analysis. RESULTS/FINDINGS: Of the caregiving care tasks most frequently performed, personal care was most difficult and household tasks were most time consuming. Family life, school, and time with friends were areas most likely to be affected by caregiving. Most subjects indicated they would permit their own children to assist with care as long as the youngster was not the sole caregiver. Youngsters need to be informed about the illness and caregiving tasks, have adequate support systems, and have some time to 'still be a child'. CONCLUSIONS: Professional caregivers should raise questions in their practice regarding involvement in caregiving by both adults and youngsters. If youngsters participate in caregiving in the home, they need to receive adequate information regarding care and the illness trajectory. Family-related research including the long-term effects of such experiences on the youngsters and their families is recommended.

Adaptation, Psychological↗
PubMed2001

African American women's experiences with the initial discovery, diagnosis, and treatment of breast cancer.

PURPOSE/OBJECTIVES: To describe the experiences of African American women living with breast cancer following the primary diagnosis and while undergoing initial treatment. DESIGN: Phenomenologic. SAMPLE/SETTING: 13 African American women (ages 30-66) purposefully selected from two oncology clinics in the mid-South. METHODS: Phenomenologic interviews (transcribed verbatim) and field notes were analyzed using Colaizzi's method of phenomenologic description and analysis. FINDINGS: Experience Trajectory, Femininity, and Spirituality were the three major themes. The Experience Trajectory subthemes were finding the lump, getting the diagnosis, undergoing surgery and adjuvant treatment. The Femininity subthemes were loss of all or part of the breast, loss of hair, and sexual attractiveness to a man. Spirituality was reflected as a reliance on God. CONCLUSIONS: Telling the story of their experience trajectory during their breast cancer experience is valuable in assessing African American women's feelings, emotions, and fears of body changes that occur during surgery and treatment. Their spirituality helps them through this experience. Research involving both African American women and their partners would provide greater insight into specific relationship patterns and communication related to sexuality during this experience. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to listen to the stories of African American women about the initial experience of discovery, diagnosis, and treatment of breast cancer so they can be more informed advocates for these women. African American women need more information from healthcare providers regarding the whole experience trajectory.

Adaptation, Psychological↗
PubMed2001

Caring demands and delay in seeking care in African American women newly diagnosed with breast cancer: an ethnographic, photographic study.

PURPOSE/OBJECTIVES: To describe the caring behaviors and demands of African American women newly diagnosed with breast cancer and to consider the influence of caring on the women's decision to delay prompt diagnosis and maintain continuing treatment. DESIGN: Focused ethnographic design using photography. SAMPLE/SETTING: 13 African American women (ages 30-66) purposefully selected from two oncology clinics in the mid-South. METHODS: Ethnographic interviews (transcribed verbatim), observations at informant-selected sites, field notes, and snapshots of caring taken by the women where caring occurred were analyzed using Lelninger's phases of ethnographic analysis. FINDINGS: Major themes were (a) generic caring for others and self as meaningful and as promoting continued commitment to diagnosis and treatment, (b) generic and professional caring from others as supportive to the women in "going on," and (c) noncaring related to a "wait and see" attitude of healthcare providers and of women in delaying early diagnosis. CONCLUSIONS: African American women's caring both for and from others was supportive in seeking and continuing diagnosis and treatment. The women with cancer viewed ensuring early diagnosis and continued treatment for other women as their "mission." Delay by providers and women requires further research. IMPLICATIONS FOR NURSING PRACTICE: Nurses must advocate assertiveness for African American women in seeking help for breast cancer symptoms and in challenging providers who adopt a "wait and see" attitude when symptoms are present. Taking snapshots, in addition to fostering the research process, is suggested as a potentially helpful intervention for women as they work through their experiences during treatment for breast cancer.

Adult↗
PubMed2001

Interdisciplinary delivery of oral health care student-training components.

The purpose of this study was to identify the interdisciplinary nature of oral health care components within Area Health Education Centers (AHECs). A questionnaire was designed to elicit descriptive information from AHEC program directors. The questionnaire surveyed the entire population of 37 AHEC project directors identified by the National AHEC Program Office. A total of 23 of 37 questionnaires were returned, for an overall response rate of 62%. Results indicate that dental and dental hygiene students are learning alongside other student health care professionals in an interdisciplinary environment. These oral health care components incorporate a variety of classroom delivery methods, such as problem-based learning, interdisciplinary learning, and reflective sessions. The survey also revealed numbers of students and programs involved in current interdisciplinary activities.

Administrative Personnel↗
PubMed1998

Youngsters caring for adults with cancer.

PURPOSE: To describe the caregiving provided by children and adolescents for adults with cancer. Because nurses are assuming an increasingly prominent role in working with caregivers, it is necessary to understand young caregivers. DESIGN: The population of interest was youngsters aged 10 to 19 caring for adults at home with cancer. Eleven children and adolescents in seven families were recruited, 1993-1994, through purposive sampling from hospices and cancer clinics. METHODS: Phenomenologic interviews, ethnographic interviews and selected participant observation experiences, and identification of needs through an unstructured survey were used. FINDINGS: "Hard, but gratifying" emerged as the dominant phenomenologic description of caregiving. Emergent ethnographic themes indicated caregiving by children and adolescents was an expectation of family life. School and church were described as avenues for social support for youngsters in care-giving situations. CONCLUSIONS: Youngsters aged 10 to 19 are caring for adults with cancer at home. Further descriptive study of youngsters caring for adults with cancer is needed.

Adaptation, Psychological↗
PubMed1997

Combining the analyses of three qualitative data sets in studying young caregivers.

Adolescent care of the adult with cancer led the authors to choose three qualitative methods to describe this unexplored phenomenon. In this study, phenomenology, ethnography and unstructured survey were combined to provide a more complete picture of the phenomenon. Data from interviews with 11 youngsters within seven family units, observations, and unstructured questionnaire, demographic data from and field notes were analysed and combined. The processes used in designing and conducting the study and analysing the data, rather than the findings, are emphasized. The data obtained by using these three methods have laid the foundation for further nursing research on caregiving by youngsters and raise questions about combining analyses of three qualitative data sets.

Adolescent↗
PubMed1996

Needs of caregivers of clinic and hospice cancer patients.

This prospective correlational study compared the self-identified needs of 55 caregivers of clinic (n = 25) and hospice (n = 30) cancer patients. Patients identified their family caregivers who filled out the Home Caregiver Need Survey (HCNS) and a demographic data form. The HCNS measures the importance and satisfaction of needs on two seven-point Likert-type scales. Descriptive statistics and t tests were used to analyze the data. Caregivers of both clinic and hospice cancer patients ranked the needs items in the Information and Spiritual categories as most important. Variation in types of information occurred between the groups. Clinic caregivers were less satisfied with how well their needs in the Information category were met. Differences between the groups in the importance scores were significant at the 0.001 level for the needs in the Patient Care and Personal Care categories. Differences in the satisfaction scores between the groups were significant at the 0.001 level for needs in the Household and Patient Care categories. The HCNS is helpful for assessing and screening caregiver needs and identifying differences in needs between groups. Health care providers in clinics and hospices must individualize teaching to meet the specific needs of caregivers, particularly those needs related to information.

Adolescent↗
PubMed1992

Qualitative research methodologies: application, Part II.

The purpose of this article is to demonstrate how selected qualitative research methods can be used by PACU nurses to study research problems applicable to their area. The qualitative methods discussed in this article are phenomenology, ethnography, grounded theory, and case study. Research questions of interest to the PACU nurse are presented, and the steps for structuring the study, collecting and analyzing the data, and reporting the findings are described. A bibliography for each method is presented in boxes throughout the article.

Humans↗
PubMed1992

Identifying the needs of home caregivers of patients with cancer.

Increasing numbers of patients with cancer are being cared for by home caregivers. The primary purpose of this methodologic, correlational study was to identify, categorize, and assess the importance of needs expressed by 492 home caregivers and to determine how well these needs were satisfied. Caregivers surveyed were selected from the records of two nonprofit community cancer agencies and two hospital outpatient oncology clinics in the Midwest. These individuals were identified by at-home patients with cancer as unpaid people who helped with physical care or coping with the disease process. Caregiver characteristics and patient activity were examined to determine their relationships to caregiver needs, and needs were examined over time. The 90-item Home Caregiver Need Survey used in this study was developed by the author in 1989 and demonstrated internal consistency, reliability, and construct validity. Using factor analysis, six need categories were identified: psychological, informational, patient care, personal, spiritual, and household. Caregivers' greatest needs were informational and psychological. Significant correlations between certain caregiver characteristics and caregiver needs and between caregiver needs and patients' activity levels were found. Both the importance and satisfying of needs changed over time. Findings indicate the urgent need for nurses, who usually provide support for caregivers, to establish specific programs and services to meet the identified and unmet informational and psychological needs of caregivers of at-home patients with cancer. Frequent reassessment of caregiver needs seems to be indicated.

Adolescent↗
PubMed1991

Qualitative research methodologies: an overview, Part I.

In these days of budget constraints and recession, PACU nurses will have to demonstrate that their nursing interventions are economical and effective. Their nursing practice needs to be shaped by scientific knowledge. The purpose of this article is to present an overview of qualitative research methods that can be used by PACU nurses. The methods described and discussed in this article include phenomenology, ethnography, grounded theory, and case studies. Part II of this article, which will be published in a subsequent issue of this journal, will present research problems that are of interest and the ways in which PACU nurses can use the qualitative research designs discussed in part I of the article.

Data Collection↗
PubMed1990

Research design conferences: guidelines for investigators and graduate students.

Meticulous preplanning will lead to a beneficial design conference and a concise successful research proposal. Selection of the best experts for the conference, organization, and a flexible conference schedule can create a profusion of ideas, enhance discussion, and allow weak areas in the proposal to be identified and strengthened. A design conference can be a delightfully rewarding strategy for investigators, research teams, or graduate students. A successful conference will be accomplished if you adhere to the following steps: 1. Have at least two design conferences while you are preparing your research proposal--more if you feel that you need them. 2. Identify and invite the best experts possible from inside and outside your institution to discuss your questions. 3. Prepare a draft of your proposal as well as a list of your questions and give these to your experts at least 1 week in advance so they can prepare for the design conference. 4. Tape-record the discussion at the design conference along with taking written notes. 5. After the conference, review the tapes and notes and revise the proposal accordingly.

Congresses as Topic↗
PubMed1989

A description of the needs of noninstitutionalized cancer patients and their primary care givers.

The purpose of this descriptive study was twofold: to identify the needs of the noninstitutionalized patient with cancer as defined by patients, primary care givers, and nurses, and to identify the needs of the primary care giver as defined by the same three groups of subjects. Each subject completed two forms of the Objects Content Test, an open-ended questionnaire on which subjects were asked to list the needs of patients and care givers. Content analysis was applied to the two sets of data to formulate categories of need responses; each set of data with category labels and definitions was submitted for q-sort by two successive groups of nurse experts to establish the validity of need item responses in categories. Findings revealed that patient needs were represented by six categories and caregivers' needs by seven categories. For both sets of data, the largest number of needs were in the psychological needs category. For patients, physical needs and information needs were the next largest categories; for care givers, the categories of household management needs (which encompassed patient care) and information needs were the second and third largest. Some disparity between perceived needs as generated by the three groups of subjects was noted. Further research utilizing quantitative methods is needed to determine whether suggested trends (such as nurse subjects' emphasis on informational needs for care givers and patients' infrequent listing of informational needs for themselves) have validity.

Adult↗
PubMedDate not supplied

Self-identified needs of patients with cancer at home and their home caregivers: a descriptive study.

Increasing numbers of patients with cancer are being cared for at home by family caregivers because of the chronicity of cancer and the transition of health care from hospital to home. This study describes the needs of 15 patients with cancer at home and 15 home caregivers. Using the Objects Content Test (OCT), 505 need statements were collected from the subjects. Three hundred patient needs and 192 caregiver needs were identified. Nurse researchers and oncology experts computer Q-sorted the 505 need statements into need categories previously established by Wingate and Lackey. Patients' greatest needs were psychological, physical, and informational. Caregivers' greatest needs were psychological, informational, and those related to household duties. Qualitative data reflected that both patients and caregivers needed support from family or friends, hope, and a sense of the future. Patients indicated a need for purposeful activities.

Adult↗
PubMedDate not supplied

Needs of hospice and clinic patients with cancer.

The purposes of this descriptive study were: (1) to compare the self-selected needs of 69 patients with cancer, 31 from a nonprofit hospice, and 38 from a university cancer center located in the mid-south; and (2) to establish the reliability of the Cancer Patient Need Survey for hospice patients. Patients completed the Cancer Patient Need Survey and a demographic data form. Hospice and clinic patients rated the category of coping needs most important. Clinic patients also ranked the category of information needs as a priority, but did not find these needs as well met. Both groups ranked as their top individual needs support from family and friends, and a patient caregiver. Reliabilities of the instrument for the groups range from 0.91 to 0.93. The Cancer Patient Need Survey is a useful instrument for assessing and testing the needs of clinic patients, but additional work needs to be done in modifying the instrument for use with hospice patients.

Adult↗